Smaller hospitals have a future in the NHS, but need to change
13 Jun 2014 04:10 PM
Small district general
hospitals can thrive but the way services are provided to local patients must
change to guarantee quality care, according to a report from
Monitor.
Monitor economists analysed a
comprehensive range of clinical and financial indicators to test whether any
special factors affected the performance of hospitals with fewer than 700 beds
(typically in trusts with an income of less than £300
million).
The research
carried out by Monitor found no clear evidence that smaller acute
hospitals performed any worse clinically than larger
counterparts.
However, the analysis showed
that there is evidence that smaller providers may be starting to face greater
financial challenges, with performance worsening more than the sector as a
whole in the last two years.
Monitor’s
recommendations
The report concludes that size
is likely to become more of an issue as hospitals face greater pressures to
recruit staff to further improve the quality of care. Monitor recommends that
the healthcare sector should:
- identify new models of care for
patients, for example re-designing services to improve the integration of
care and move it closer to home
- come up with creative ways to
address the scale challenges, such as sharing staff with nearby trusts, using
new technology, or building networks between smaller hospitals and major
centres
- make sure that the right balance
is struck in local communities between redesigning services and making sure
patients are treated near to where they live
David Bennett, Chief Executive
at Monitor, said:
People value their local
hospitals and we wanted to understand the challenges that they face as the NHS
takes on a potential £30 billion funding gap over the next
decade.
We found that smaller hospitals
are facing increasing challenges but with the system’s support can
continue to play an important role in the nation’s health
service.
Bigger isn’t always better
and just merging or taking a ‘one size fits all’ approach to local
health services is not the answer. We need to achieve the right balance between
risks to quality and risks to access, and consider other constraints such as
the impact of clinical specialisation to make sure patients continue to benefit
from the local hospitals that they value so much.
Terence Stephenson, Chairman at
The Academy of Medical Royal Colleges, said:
This is a valuable report and it
has been welcome that Colleges have been able to provide advice and input
through the Clinical Advisory Group established for the project. Providing the
right services for patients in the right place that can be financially and
clinically viable is one of the NHS’s absolutely key
challenges.
It’s clear from this
report that that there are no simple conclusions or answers to these questions.
But the report provides the service with a useful base for taking forward
thinking and practical action.
Facing the future: smaller acute
providers
Find out
more about the report’s findings